Abstract
Amaç: Çalışmamızda böbrek içi toplam taş yükü 1.5 cm ve altında olan hastaların tedavisinde erişim kılıflı flexible üreterorenoskopi ve erişim kılıfsız Flexible-URS kulanımının etkinlik ve güvenilirliklerini karşılaştırmayı amaçladık.
Gereç Ve Yöntem: Böbrek pelvisinde, orta ve üst kalikste toplam taş yükü 0,8 ile 1,5 cm arasında olan ve üreterorenoskopik taş cerrahisi yapılan toplam 70 vakanın verileri geriye dönük retrospektif olarak değerlendirildi. Üreteral erişim kılıfsız F-URS (n=32) ve üreteral erişim kılıflı F-URS (n=38) uygulanan hastaların verileri retrospektif olarak incelendi. Gruplar arasında stone-free oranları, ameliyat süreleri, floroskopiye maruziyet süresi, kan kaybı ve komplikasyonlar açısından karşılaştırma yapıldı.
Bulgular: Toplam taş yükü 1.5 cm ve altında olan 70 hastanın 32'inde (%45,7) erişim kılıfsız F-URS yapılırken, 38 (%54,3) hastaya ise erişim kılıflı F-URS yapıldı. Vakaların yaşı, cinsiyeti, toplam taş boyutu ve taş tarafı her iki grupta da anlamlı farklılık yoktu. Ortalama operasyon süresi erişim kılıfsız F-URS grubunda 98,42±8,12 dk, erişim kılıflı F-URS grubunda ise 101,23±9,08 dk idi ve istatistiksel olarak anlamlı değildi (p=0.303). İntraoperatif kullanılan floskopi süresi her iki gurupta da benzer olup aralarındaki fark anlamlı bulunmadı (p=0,313). Ameliyat sonrası 1. gün ve 1. ay takipte stone-free oranları erişim kılıfsız F-URS grubunda sırasıyla %81,48 ve % 85,18 iken, erişim kılıflı F-URS grubunda ise %81,25 ve %87,5 olup iki gurup arasında stone-free başarısı yönünden istatiksel olarak anlamlı bir fark bulunmadı (p=0,896 ve p=0,674).
Sonuç: Toplam böbrek içi taş yükü 1.5 cm ve altında olan hastalarda erişim kılıfsız F-URS ile erişim kılıflı F-URS kıyaslandığında benzer ameliyat sürelerine, benzer başarı ve komplikasyon oranlarına sahiptir.
Keywords
Supporting Institution
HİÇBİR KURUMDAN DESTEK ALINMAMIŞTIR.
References
- 1. Cooper JL, François N, Sourial MW, 2020. The impact of ureteral access sheath use on the development of abnormal postoperative upper tract imaging after ureteroscopy. J Urol. ,204(5):976-981.
- 2. Traxer O, Nordahl GW, Sodha H, 2015. Differences in renal stone treatment and outcomes for patients treated either with or without the support of a ureteral access sheath: The Clinical Research Office of the Endourological Society Ureteroscopy Global Study. World J Urol; 33(12):2137–2144
- 3. Stern JM, Yiee J, Park S. 2007. Safety and efficacy of ureteral access sheaths. J Endourol 2007;21(2):119-123.
- 4. Rehman J, Monga M, Landman J 2003. Characterization of intrapelvic pressure during ureteropyeloscopy with ureteral access sheaths. Urology 2003;61(4):713–718.
- 5. Kourambas J, Byrne RR, Preminger GM. 2001. Does a ureteral access sheath facilitate ureteroscopy? J Urol ;165(3):789–793
- 6. Auge BK, Pietrow PK, Lallas CD 2004. Ureteral Access sheath provides protection against elevated renal pressures during routine flexible ureteroscopic stone manipulation. J Endourol 2004;18(1):33–36.
- 7. L’Esperance JO, Ekeruo WO, Scales CD, 2005 . Effect of ureteral access sheath on stone-free rates in patients undergoing ureteroscopic management of renal calculi. Urology;66(2):252–255.
- 8. Turk C, Knoll T, Petrik A, 2015. Guidelines on urolithiasis. European Association of Urology 2015; http://www.uroweb.org/gls/pdf/22%20Urolithiasis_LR.pdf. Accessed 9 Jan
- 9. Al-Qahtani SM, Letendre J, Thomas A, 2014. Which ureteral access sheath is compatible with your flexible ureteroscope? J Endourol , 28(3):286–290
- 10. Tapiero S, Gill S, Limfueco L, 2014. Impact of ureteral access sheath diameter on the outcomes of flexible ureteroscopic stone removal as determıned by the ureteroscopic stone efficiency quotıent. World J Urol (4S);32:229–232.
- 11. Geraghty RM, Ishii H, Somani BK.2016. Outcomes of flexible ureteroscopy and laser fragmentation for treatment of large renal stones with and without the use of ureteral access sheaths: Results from a university hospital with a review of literatüre. Scand J Urol. ;50(3):216–219. .
- 12. Berquet G, Prunel P, Verhoest G, et al. The use of ureteral access sheath does not improve stone-free rate after ureteroscopy for upper urinary tract stones. World J Urol 2014; 32(1):229–232
- 13. Chen Y, Liao B, Feng S,2018. Ureteral access sheath in flexible ureteroscopic lithotripsy. Journal of Endourology ;32(10):923-927
- 14. Lima A, Reeves T, Geraghty R, 2020. Impact of ureteral access sheath on renal stone treatment: prospective comparative non-randomised outcomes over a 7-year period. World Journal of Urology ;38:1329–1333
Abstract
References
- 1. Cooper JL, François N, Sourial MW, 2020. The impact of ureteral access sheath use on the development of abnormal postoperative upper tract imaging after ureteroscopy. J Urol. ,204(5):976-981.
- 2. Traxer O, Nordahl GW, Sodha H, 2015. Differences in renal stone treatment and outcomes for patients treated either with or without the support of a ureteral access sheath: The Clinical Research Office of the Endourological Society Ureteroscopy Global Study. World J Urol; 33(12):2137–2144
- 3. Stern JM, Yiee J, Park S. 2007. Safety and efficacy of ureteral access sheaths. J Endourol 2007;21(2):119-123.
- 4. Rehman J, Monga M, Landman J 2003. Characterization of intrapelvic pressure during ureteropyeloscopy with ureteral access sheaths. Urology 2003;61(4):713–718.
- 5. Kourambas J, Byrne RR, Preminger GM. 2001. Does a ureteral access sheath facilitate ureteroscopy? J Urol ;165(3):789–793
- 6. Auge BK, Pietrow PK, Lallas CD 2004. Ureteral Access sheath provides protection against elevated renal pressures during routine flexible ureteroscopic stone manipulation. J Endourol 2004;18(1):33–36.
- 7. L’Esperance JO, Ekeruo WO, Scales CD, 2005 . Effect of ureteral access sheath on stone-free rates in patients undergoing ureteroscopic management of renal calculi. Urology;66(2):252–255.
- 8. Turk C, Knoll T, Petrik A, 2015. Guidelines on urolithiasis. European Association of Urology 2015; http://www.uroweb.org/gls/pdf/22%20Urolithiasis_LR.pdf. Accessed 9 Jan
- 9. Al-Qahtani SM, Letendre J, Thomas A, 2014. Which ureteral access sheath is compatible with your flexible ureteroscope? J Endourol , 28(3):286–290
- 10. Tapiero S, Gill S, Limfueco L, 2014. Impact of ureteral access sheath diameter on the outcomes of flexible ureteroscopic stone removal as determıned by the ureteroscopic stone efficiency quotıent. World J Urol (4S);32:229–232.
- 11. Geraghty RM, Ishii H, Somani BK.2016. Outcomes of flexible ureteroscopy and laser fragmentation for treatment of large renal stones with and without the use of ureteral access sheaths: Results from a university hospital with a review of literatüre. Scand J Urol. ;50(3):216–219. .
- 12. Berquet G, Prunel P, Verhoest G, et al. The use of ureteral access sheath does not improve stone-free rate after ureteroscopy for upper urinary tract stones. World J Urol 2014; 32(1):229–232
- 13. Chen Y, Liao B, Feng S,2018. Ureteral access sheath in flexible ureteroscopic lithotripsy. Journal of Endourology ;32(10):923-927
- 14. Lima A, Reeves T, Geraghty R, 2020. Impact of ureteral access sheath on renal stone treatment: prospective comparative non-randomised outcomes over a 7-year period. World Journal of Urology ;38:1329–1333
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research Articles |
| Authors | |
| Publication Date | August 31, 2022 |
| Submission Date | June 3, 2022 |
| Published in Issue | Year 2022 Volume: 15 Issue: 2 |
Van Health Sciences Journal (Van Sağlık Bilimleri Dergisi) başlıklı eser bu Creative Commons Atıf-Gayri Ticari 4.0 Uluslararası Lisansı ile lisanslanmıştır.
